Priyadarshini Saundarya, Agarwala Sandeep, Priya Harsh, Jain Vishesh, Goel Prabudh, Dhua Anjan Kumar, Yadav Devendra Kumar, Anand Sachit, Patel Nishant
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Public Health Dentistry, CDER All India Institute of Medical Sciences, New Delhi, India.
J Indian Assoc Pediatr Surg. 2024 Sep-Oct;29(5):465-478. doi: 10.4103/jiaps.jiaps_62_24. Epub 2024 Aug 23.
Virtual reality (VR) refers to a computer-generated simulation or environment that can be experienced and interacted with by a person through special electronic equipment, such as a headset with a screen and motion-tracking sensors. VR has been used as a distraction technique to alleviate pain and discomfort during medical procedures or as an alternative to traditional pain medication. This article explores VR's effectiveness in reducing pain in pediatric patients undergoing painful clinical procedures.
This systematic review and meta-analysis was performed as per the preferred reporting item for systematic review and meta-analysis guidelines. A systematic literature search was conducted for all articles published till December 2022 in four different databases: PubMed, Scopus, Embase, and LILACS, which yielded 6886 studies. Studies showing the effect of VR on pediatric patients undergoing clinical procedures were included in the study. Risk of bias (ROB) 2.0 was used to assess the ROB. Outcome data were pooled using a random-effects model and reported as standardized mean difference (SMD) with a 95% confidence interval (CI). The meta-analysis was performed on RevMan5.4. Subgroup analysis was done for the different clinical procedures.
A total of 2477 participants from 34 studies were included in the meta-analysis. Children in whom VR was used had a significantly lower pain score as compared to the control group with an SMD of 0.87 (CI 95% -1.20, -0.53; ( < 0.00001). Subgroup analysis based on the type of intervention did not reveal any significant difference ( = 0.19). Heterogeneity for overall pain using a random effect model with was significant ( < 0.00001).
This systematic review suggests that the use of VR distraction in children undergoing painful procedures is associated with significantly lower pain scores. Hence, VR can be a promising intervention for reducing pain experienced by pediatric patients during medical procedures.
虚拟现实（VR）是指一种计算机生成的模拟或环境，人们可以通过特殊的电子设备，如带有屏幕和运动跟踪传感器的头戴式设备来体验并与之交互。VR已被用作一种分散注意力的技术，以减轻医疗程序中的疼痛和不适，或作为传统止痛药的替代品。本文探讨了VR在减轻接受痛苦临床程序的儿科患者疼痛方面的有效性。
本系统评价和荟萃分析按照系统评价和荟萃分析指南的首选报告项目进行。在四个不同的数据库（PubMed、Scopus、Embase和LILACS）中对截至2022年12月发表的所有文章进行了系统的文献检索，共检索到6886项研究。纳入显示VR对接受临床程序的儿科患者有影响的研究。使用偏倚风险（ROB）2.0来评估偏倚风险。使用随机效应模型汇总结果数据，并报告为标准化平均差（SMD）及95%置信区间（CI）。在RevMan5.4上进行荟萃分析。对不同的临床程序进行亚组分析。
荟萃分析共纳入了来自34项研究的2477名参与者。与对照组相比，使用VR的儿童疼痛评分显著更低，标准化平均差为0.87（95%CI -1.20，-0.53；P<0.00001）。基于干预类型的亚组分析未显示任何显著差异（P=0.19）。使用随机效应模型且I²为0.97时，总体疼痛的异质性显著（P<0.00001）。
本系统评价表明，在接受痛苦程序的儿童中使用VR分散注意力与显著更低的疼痛评分相关。因此，VR可能是一种有前景的干预措施，可减轻儿科患者在医疗程序中所经历的疼痛。
